Camille P Figueiredo1, Arnd Kleyer2, David Simon2, Fabian Stemmler2, Isabelle d'Oliveira2, Anja Weissenfels3, Oleg Museyko3, Andreas Friedberger3, Axel J Hueber2, Judith Haschka4, Matthias Englbrecht2, Rosa M R Pereira5, Juergen Rech2, Georg Schett2, Klaus Engelke6. 1. Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany; Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 2. Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany. 3. Institute of Medical Physics (IMP), Friedrich-Alexander-University Erlangen-Nüremberg (FAU), Henkestrasse 91, Erlangen 91052, Germany. 4. Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany; St. Vincent Hospital, Medical Department II, VINFORCE Study Group, Academic Teaching Hospital of Medical University of Vienna, Vienna, Austria. 5. Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. 6. Institute of Medical Physics (IMP), Friedrich-Alexander-University Erlangen-Nüremberg (FAU), Henkestrasse 91, Erlangen 91052, Germany. Electronic address: klaus.engelke@imp.uni-erlangen.de.
Abstract
OBJECTIVE: The comparison between different techniques to quantify the 3-dimensional size of inflammatory bone erosions in rheumatoid arthritis(RA) patients. METHODS: Anti-cyclic citrullinated peptide antibody(ACPA) positive RA patients received high-resolution peripheral quantitative computed tomography (HR-pQCT) scans of the metacarpophalangeal joints (MCP). Erosions were measured by three different segmentation techniques: (1) manual method with calculation by half-ellipsoid formula, (2) semi-automated modified Evaluation Script for Erosions (mESE), and (3) semi-automated Medical Image Analysis Framework (MIAF) software. Bland & Altman plots were used to describe agreement between methods. Furthermore, shape of erosions was classified as regular or irregular and then compared to the sphericity obtained by MIAF. RESULTS: A total of 76 erosions from 65 RA patients (46 females/19 males), median age 57 years, median disease duration 6.1 years and median disease activity score 28 of 2.8 units were analyzed. While mESE and MIAF showed good agreement in the measurement of erosion size, the manual method with calculation by half-ellipsoid formula underestimated erosions size, particularly with larger erosions. Accurate segmentation is particularly important in larger erosions, which are irregularly shaped. In all three segmentation techniques irregular erosions were larger in size than regular erosions (MIAF: 19.7 vs. 3.4mm3; mESE: 15.5 vs. 2.3mm3; manual = 7.2 vs. 1.52mm3; all p < 0.001). In accordance, sphericity of erosions measured by MIAF significantly decreased with their size (p < 0.001). CONCLUSION: MIAF and mESE allow segmentation of inflammatory bone erosions in RA patients with excellent inter reader reliability. They allow calculating erosion volume independent of erosion shape and therefore provide an attractive tool to quantify structural damage in individual joints of RA patients.
OBJECTIVE: The comparison between different techniques to quantify the 3-dimensional size of inflammatory bone erosions in rheumatoid arthritis(RA) patients. METHODS: Anti-cyclic citrullinated peptide antibody(ACPA) positive RApatients received high-resolution peripheral quantitative computed tomography (HR-pQCT) scans of the metacarpophalangeal joints (MCP). Erosions were measured by three different segmentation techniques: (1) manual method with calculation by half-ellipsoid formula, (2) semi-automated modified Evaluation Script for Erosions (mESE), and (3) semi-automated Medical Image Analysis Framework (MIAF) software. Bland & Altman plots were used to describe agreement between methods. Furthermore, shape of erosions was classified as regular or irregular and then compared to the sphericity obtained by MIAF. RESULTS: A total of 76 erosions from 65 RApatients (46 females/19 males), median age 57 years, median disease duration 6.1 years and median disease activity score 28 of 2.8 units were analyzed. While mESE and MIAF showed good agreement in the measurement of erosion size, the manual method with calculation by half-ellipsoid formula underestimated erosions size, particularly with larger erosions. Accurate segmentation is particularly important in larger erosions, which are irregularly shaped. In all three segmentation techniques irregular erosions were larger in size than regular erosions (MIAF: 19.7 vs. 3.4mm3; mESE: 15.5 vs. 2.3mm3; manual = 7.2 vs. 1.52mm3; all p < 0.001). In accordance, sphericity of erosions measured by MIAF significantly decreased with their size (p < 0.001). CONCLUSION: MIAF and mESE allow segmentation of inflammatory bone erosions in RApatients with excellent inter reader reliability. They allow calculating erosion volume independent of erosion shape and therefore provide an attractive tool to quantify structural damage in individual joints of RApatients.
Authors: Lukas Folle; Timo Meinderink; David Simon; Anna-Maria Liphardt; Gerhard Krönke; Georg Schett; Arnd Kleyer; Andreas Maier Journal: Sci Rep Date: 2021-05-06 Impact factor: 4.379
Authors: Eleni Kampylafka; Isabelle d'Oliveira; Christina Linz; Veronika Lerchen; Fabian Stemmler; David Simon; Matthias Englbrecht; Michael Sticherling; Jürgen Rech; Arnd Kleyer; Georg Schett; Axel J Hueber Journal: Arthritis Res Ther Date: 2018-07-27 Impact factor: 5.156
Authors: Camille P Figueiredo; Mariana O Perez; Lucas Peixoto Sales; Ana Cristina Medeiros; Valeria F Caparbo; Rosa M R Pereira Journal: BMC Musculoskelet Disord Date: 2021-01-25 Impact factor: 2.362